Association of body mass index, sagittal abdominal diameter and waist-hip ratio with cardiometabolic risk factors and adipocytokines in Arab children and adolescents

Abstract

BackgroundSagittal abdominal diameter (SAD) is a novel anthropometric measure hypothesized to be a surrogate measure of visceral abdominal obesity in adults. This study aims to determine whether SAD is superior to other anthropometric measures such as body mass index (BMI) and waist to hip ratio (WHR) in terms of association to cardiometabolic risk and circulating adipocytokine concentrations in a cohort of Saudi children and adolescents.MethodsA total of 948 (495 boys and 453 girls) apparently healthy children with varying BMI, aged 10–17 years, were included in this cross sectional study. Fasting glucose, lipid profile, leptin, adiponectin, resistin, insulin, TNF-α and aPAI-1 were measured in serum and HOMA-IR was calculated. MetS components were defined according to the International Diabetes Federation (IDF) criteria.ResultsBMI was superior to SAD as well as WHR, and had the highest number of significant associations to MetS components and adipocytokines even after adjustment for age and gender, including blood pressure, lipids, glucose and leptin.ConclusionIn conclusion, while SAD is significantly associated with components of MetS among children and adolescents, it is not superior to BMI. The use of SAD therefore may not be practical for use in the pediatric clinical setting. Follow-up studies are needed to determine whether SAD has clinical significance in terms of harder outcomes such as predicting diabetes mellitus or cardiovascular diseases.

Sagittal abdominal diameter resembles waist circumference as a surrogate marker of insulin resistance in adolescents-Brazilian Metabolic Syndrome Study

“…Our results are in line with studies in adults that have shown that the SAD was inversely associated with the clamp‐derived measure of insulin sensitivity . Studies have examined the relation between SAD and IR assessed by HOMA‐IR in pediatric population . However, these previous studies did not consider pubertal development.…”

“…Despite the differences in the statistical analyses between the studies, our results agree with that found in a study of Indian obese and overweight adolescents (aged 10‐18 years), that also showed that the SAD was positively correlated with the HOMA‐IR after adjusting for age and sex . However, contrary to our data, a study of Saudi adolescents (aged between 10 and 17 years), did not observe significant correlation between the SAD and the HOMA‐IR after adjusting for sex and age . However, their statistical analysis was conducted with SAD z ‐scores.…”

“…Regarding usefulness of SAD in the evaluation of components of the MetS, previous studies are controversial . Similar to ours, a study of Saudi adolescents (aged 10‐17 years), showed that SAD was positively correlated with blood pressure (systolic and diastolic) and triglycerides, and inversely correlated with HDL‐cholesterol even after adjusting for age and sex . Another one, in line with ours, studied overweight and obese American children and adolescents (8‐12 years old) and showed that SAD was positively correlated with triglycerides and systolic blood pressure.…”

Anthropometric measures of abdominal adiposity for the identification of cardiometabolic risk factors in adolescents

“…Findings of previous studies comparing the ability of BMI and measures of abdominal adiposity to identify cardiometabolic risk factors are conflicting. WC has been found to be associated with cardiometabolic risk factors independent of BMI in some studies [14, 15] while others have found that measures of abdominal adiposity are not better than BMI for the identification of cardiometabolic risk [16, 17]. A recent study reported measures of abdominal adiposity were not better predictors of VAT than BMI in children [18], which may explain these negative findings.…”

Prognostic importance of anthropometrics in obesity related cardiovascular risk factors in children

“…Diğer taraftan 22±2 yaşındaki öğrencilerin incelendiği bir çalışmada kardiyovasküler risk faktörlerinden hipertansiyon için VKİ'nin, anormal serum lipidleri için bel çevresi ve bel/boy oranının iyi bir prediktör olduğu gösterilmiştir (23). VKİ'nin diğer parametrelere daha üstün olduğunu bildiren çalışmalar da vardır (24). Bizim çalışmamızda, kardiyovasküler risk faktörlerini öngörmede bel/boy oranının VKİ, VYY ve bel/kalça oranına göre daha iyi bir prediktör olduğu görüldü.…”